We used the RIETE Registry data to compare the clinical characteristics, treatment strategies and outcome in cancer patients with unsuspected pulmonary embolism (PE) and in those presenting with symptomatic, acute PE. 78 cancer patients with unsuspected PE and 1,994 with symptomatic PE had been enrolled. Our findings suggest that the clinical characteristics and outcome in cancer patients with unsuspected PE are quite similar to those in patients with symptomatic PE.